46 Skin Biopsy
Susan Spence
Skin Biopsy is a very valuable tool to diagnose primary and secondary skin conditions-in general the rule is to “go big or go home,” in other words, a larger sample size 8 mm skin biopsy punch is preferred over smaller 3 mm skin biopsy punch in most cases.
Important points to remember!
- Be aware of anatomy of area to avoid blood vessels, nerves and other sensitive structures.
- Be careful! biopsy punches are extremely sharp! Don’t clean and reuse…
- Only submit abnormal tissue!-you don’t want to risk the pathologist missing abnormal tissue if you submit half normal and half abnormal when your sample is sectioned.
- Include a description, location, size in 3 dimensions, history, as well as duration and progression of lesion. Picture with ruler and animal ID is helpful and appreciated by pathologists.
- Use one hand to steady the area around the site, and concentrate and “be the skin” so you are aware of subtle changes in resistance as you move from epidermis/dermis/SQ fat
- Do not disrupt crusts on top of lesion as these can be helpful in diagnosis
- Turn the biopsy punch in one direction only (usually to the right to make cut) no back and forth.
- Use syringe needle of small gauge to gently pry out the sample-NOT forceps which can crush and distort your sample.
- Trim SQ fat with iris scissors if needed
- Apply direct pressure to biopsy site, and close with single cruciate suture
- Take several representative samples if area is large
Video of Skin Biopsy Punch Usage
IN A NUT SHELL:
- Know your underlying anatomy!
- Describe lesion, location, size, duration, progression, Hx, and picture!
- Only biopsy ABNORMAL tissue
- Turn biopsy punch in one direction only
- Lift out sample with small syringe needle, not forceps
- Direct Pressure with gauze
- Close with Cruciate